细胞间黏附分子-1在高血压左室肥厚发病中的作用

目的　研究细胞间黏附分子 - 1(ICAM - 1)在高血压左室肥厚发生中的作用。方法　 12周龄雄性WKY大鼠和自发性高血压大鼠 (SHR)共 34只 ,分为对照组、高血压组、抗ICAM - 1抗体治疗组。抗ICAM - 1抗体治疗组经尾静脉注射抗ICAM - 1单克隆抗体 12周。断头处死大鼠后留取心肌标本 ,进行HE、VG染色 ,观察心肌细胞形态和胶原分布情况 ;免疫组化染色及ED1标记显示心肌巨噬细胞浸润 ;逆转录 -聚合酶链反应 (RT -PCR)检测心肌ICAM - 1mRNA表达 ;酶链免疫吸附实验 (ELISA)检测ICAM - 1的蛋白表达。结果　与对照组WKY大鼠比较 ,SHR肥厚心肌中ICAM - 1的mRNA及蛋白表达显著增加 (P <0 0 1,P <0 0 5 ) ,巨噬细胞浸润明显 (P <0 0 1)。应用抗ICAM - 1抗体治疗后 ,SHR心肌ICAM - 1的表达水平显著下调 (P <0 0 1,P <0 0 5 ) ,巨噬细胞浸润数减少 (P <0 0 5 ) ,心肌细胞肥大和间质纤维化程度明显减轻。结论　在高血压左室肥厚的发病过程中 ,心肌ICAM - 1过度表达及其介导的炎性细胞浸润可能具有重要作用     

细胞间黏附分子-1在高血压左室肥厚发病中的作用及丹参酮ⅡA对其表达的影响

目的:探讨细胞间黏附分子-1(ICAM-1)在高血压左室肥厚发生中的作用及丹参酮ⅡA对其表达的影响.方法:12周龄雄性Wistar-Kyoto(WKY)大鼠和自发性高血压大鼠(SHR)共30只,随机分为对照组、高血压组、丹参酮ⅡA组.丹参酮ⅡA组经尾静脉连续注射丹参酮ⅡA 治疗12周.断头处死大鼠后留取心肌标本,进行苏木素-伊红(HE)、范吉逊(VG)染色,观察心肌细胞形态和胶原分布情况;免疫组化染色及ED1标记显示心肌巨噬细胞浸润;逆转录-聚合酶链反应检测心肌ICAM-1 mRNA表达;酶联免疫吸附试验(ELISA)检测ICAM-1的蛋白表达.结果:与对照组WKY大鼠比较,SHR组肥厚心肌中ICAM-1的mRNA及蛋白表达均显著增加(P<0.01和P<0.05),巨噬细胞浸润明显(P<0.01).应用丹参酮ⅡA治疗后,SHR组的心肌ICAM-1的mRNA及蛋白表达水平均显著下调(P<0.01和P<0.05),巨噬细胞浸润数减少(P<0.05),心肌细胞肥大和间质纤维化程度明显减轻.结论:心肌ICAM-1过度表达及其介导的炎性细胞浸润在高血压左室肥厚的发病过程中具有重要作用;丹参酮ⅡA抑制左室肥厚的效应可能与其下调ICAM-1表达,减少炎性细胞的心肌浸润有关.     

高血压左室肥厚发病中细胞间黏附分子1的表达及丹参酮ⅡA的抑制效应

背景细胞间黏附分子1作为炎症反应的可靠标志物在动脉粥样硬化发病中具有重要的作用.近年来研究认为其介导的慢性炎症反应可能参与高血压左室肥厚的发病过程,但也有报道持相反观点.丹参酮ⅡA是丹参的一种脂溶性提取性,动物实验证明其具有抑制高血压左室肥厚发生的作用.目的探讨细胞间黏附分子1在高血压左室肥厚发生中的作用及丹参酮ⅡA对其表达的影响.设计随机对照观察.单位华中科技大学同济医学院附属同济医院.材料实验于2002-10/2004-01在华中科技大学同济医学院附属同济医院急诊科实验室完成,选用12周龄雄性WKY大鼠10只、自发性高血压SHR大鼠20只,分为对照组(WKY大鼠10只)、高血压组(SHR大鼠10只)、丹参酮ⅡA组(SHR大鼠10只).方法丹参酮ⅡA组经尾静脉注射丹参酮ⅡA 1.5 mg/(kg·d)治疗,其他两组分别注射等量的蒸馏水.12周后断头处死所有大鼠留取心肌标本,应用苏木精-伊红染色、VG染色,免疫组化染色及心肌ED1标记检测心肌巨噬细胞浸润数,心肌细胞间黏附分子1 mRNA及蛋白的表达应用反转录-聚合酶链反应及酶链免疫吸附实验等方法.主要观察指标各组大鼠心肌巨噬细胞浸润数,心肌细胞间黏附分子1mRNA及蛋白表达.结果20只SHR和10只WKY大鼠被纳入实验,并全部进入结果分析,无脱失值.①与对照组比较,高血压组大鼠肥厚心肌中细胞间黏附分子1的mRNA及蛋白表达显著增加(0.176±0.087,0.537±0 195;0.104±0.011,0.173±0.027,P＜0.01或P＜0.05),巨噬细胞浸润明显(0.62±0.07,1.85±0.23,P＜0.01).②与高血压组比较,丹参酮ⅡA组大鼠心肌细胞间黏附分子1的mRNA及蛋白表达水平显著下调(0.537±0.195,0.291±0.106;0.173±0.027,0.125±0.014,P＜0.01或P＜0.05),巨噬细胞浸润数减少(1.85±0.23,1.16±0.17,P＜0.05),心肌细胞肥大和间质纤维化程度明显减轻.结论心肌细胞间黏附分子1的过度表达及其介导的炎性细胞浸润在高血压左室肥厚的发病过程中具有重要作用.丹参酮ⅡA抑制左室肥厚的效应可能与其下调细胞间黏附分子1表达,减少炎性细胞的心肌浸润有关.     

高血压左室肥厚发病中细胞间黏附分子1的表达及丹参酮ⅡA的抑制效应

背景：细胞间黏附分子1作为炎症反应的可靠标志物在动脉粥样硬化发病中具有重要的作用。近年来研究认为其介导的慢性炎症反应可能参与高血压左室肥厚的发病过程，但也有报道持相反观点。丹参酮ⅡA是丹参的一种脂溶性提取性，动物实验证明其具有抑制高血压左室肥厚发生的作用。目的：探讨细胞间黏附分子1在高血压左室肥厚发生中的作用及丹参酮ⅡA对其表达的影响。设计：随机对照观察。单位：华中科技大学同济医学院附属同济医院。材料：实验于2002—10／2004—01在华中科技大学同济医学院附属同济医院急诊科实验室完成，选用12周龄雄性WKY大鼠10只、自发性高血压SHR大鼠20只，分为对照组(WKY大鼠10只)、高血压组(SHR大鼠10只)、丹参酮ⅡA组(SHR大鼠10只)。方法：丹参酮ⅡA组经尾静脉注射丹参酮ⅡA1．5mg／(kg&;#183;d)治疗，其他两组分别注射等量的蒸馏水。12周后断头处死所有大鼠留取心肌标本，应用苏木精-伊红染色、VG染色，免疫组化染色及心肌EDI标记检测心肌巨噬细胞浸润数，心肌细胞间黏附分子1mRNA及蛋白的表达应用反转录一聚合酶链反应及酶链免疫吸附实验等方法。主要观察指标：各组大鼠心肌巨噬细胞浸润数，心肌细胞间黏附分子1mRNA及蛋白表达。结果：20只SHR和10只WKY大鼠被纳入实验，并全部进入结果分析，无脱失值。①与对照组比较，高血压组大鼠肥厚心肌中细胞间黏附分子1的mRNA及蛋白表达显著增加(0．176&;#177;0．087，0．537&;#177;0．195；0．104&;#177;0．011，0．173&;#177;0．027，P&;lt;0．01或P&;lt;0．05)，巨噬细胞浸润明显(0．62&;#177;0．07，1．85&;#177;0．23，P&;lt;0．01)。②与高血压组比较，丹参酮ⅡA组大鼠心肌细胞间黏附分子1的mRNA及蛋白表达水平显著下调(0．537&;#177;0．195，0．291&;#177;0．106；0．173&;#177;0．027，0．125&;#177;0．014．P&;lt;0．01或P&;lt;0．05)，巨噬细胞浸润数减少(1．85&;#177;0．23。1．16&;#177;0．17，P&;lt;0．05)，心肌细胞肥大和间质纤维化程度明显减轻。结论：心肌细胞间黏附分子1的过度表达及其介导的炎性细胞浸润在高血压左室肥厚的发病过程中具有重要作用。丹参酮ⅡA抑制左室肥厚的效应可能与其下调细胞间黏附分子1表达，减少炎性细胞的心肌浸润有关。     

氯沙坦对SHR心肌及心肌血管周围胶原影响的实验研究

【目的】探讨氯沙坦治疗对自发性高血压大鼠 (SHR)左心室心肌及心肌周围胶原纤维增殖的影响。【方法】以 4 2只 12周龄雄性SHR为对象 ,分为氯沙坦治疗组 (SHR L ,30mg·kg-1·d-1)及未服药组(SHR C) ,每组 2 1只 ;另以 2 1只WKY大鼠为正常对照组。治疗组降压治疗 12周。同步测量各组收缩压 ,测量左心室重量 ,计算心脏左室重量与体重比值 (LV/BW ) ,测量心肌间质胶原容积分数 (CVF)和心肌血管周围胶原面积 (PVCA)。【结果】①SHR L组LV/BW明显降低 (P <0 .0 1) ,随治疗时间的延长其降低程度越明显。②WKY组 12～ 2 4周龄CVF、PVCA明显增加 ,差异有显著性 (P <0 .0 5 )。SHR C组随周龄增加其CVF、PVCA值亦升高 (P <0 .0 5 ) ;与同周龄WKY比较 ,CVF及PVCA明显升高 (P <0 .0 5 )。SHR L组与SHR C组比较 ,CVF、PVCA明显下降 (P <0 .0 5 ) ,接近WKY组 (P >0 .0 5 )。【结论】氯沙坦使胶原异常增生明显得到抑制 ,并促进胶原蛋白降解 ,从而预防和阻止心肌纤维化 ,使SHR肥厚左室明显逆转 ,     

自发性高血压大鼠NHE-1基因表达与左心室肥厚的相关性

目的：探讨自发性高血压大鼠（SHR）NHE-1基因表达与左心室肥厚的相关性.方法：对SHR和同源血压正常大鼠（WKY）进行平均血压、左室重量（LVW）和体重（BW）的测定，同时采用实时定量荧光检测两组大鼠心肌组织中NHE-1 mRNA的拷贝数.结果：SHR组与WKY组相比，SHR组的LVW、LVW/BW明显高于WKY组（r左室重=0.700，r左室重/体重之比=0.617，P＜0.01），大鼠的平均血压与LVW量、LVW/BW呈正相关（P＜0.01）；SHR组的心肌组织NHE-1 mRNA的表达增高（P＜0.01）.结论：SHR的心肌组织NHE-1 mRNA的表达增高，提示NHE-1可能参与心肌肥厚的发生、发展过程.     

丹参对自发性高血压大鼠左室肥厚及心脏局部醛固酮的作用

目的　探究长期应用丹参对自发性高血压大鼠 (SHR)左室肥厚的预防作用及其可能机制———抑制心脏局部醛固酮的作用。方法　实验动物采用WKY大鼠及SHR ,部分SHR给予丹参注射液腹腔注射 12周。测量收缩压、左心室重量指数 ;左心室组织切片用HE染色和VanGieson染色 ,全自动图象分析系统进行分析。用放免法测定心脏局部醛固酮含量。各组指标进行显著性检验。结果　与WKY大鼠相比较 ,SHR有较高的血压 ,左室胶原含量及心脏局部醛固酮含量升高 (P <0 .0 5 )。而应用丹参后 ,除收缩压外各指标均有显著性下降 (P<0 .0 5 )。结论　丹参能预防自发性高血压大鼠左室肥厚 ,抑制左室胶原合成 ,其机制可能于抑制心脏局部醛固酮作用有关     

丹参预防自发性高血压大鼠左室肥厚及对转移生长因子β1的影响

目的　观察丹参对自发性高血压大鼠左室肥厚的作用 ,探讨其作用机制。方法　 18只 8周龄的自发性高血压大鼠随机分成 3组 ,1组于 8周处死 ,另 2组分别经腹腔注射丹参或蒸馏水 ( 1g·kg- 1 ·d- 1 ) ,共 10周。测量大鼠尾动脉收缩压 (SBP)及左心室重量指数 (LVMI)。检测心肌细胞的直径 (TDM)和面积 (CA)、心肌组织胶原容积积分 (CVF)、血管周围胶原面积和管腔面积比例 (PVCA)以及转移生长因子 - β1 (TGF - β1 )的表达。结果　与 8周龄的自发性高血压大鼠相比 ,18周龄大鼠的SBP、LVMI、TDM、CA、CVF和PVCA显著增加 ,TGF - β1 表达上调 ,丹参对自发性高血压大鼠可抑制左室肥厚的发展和心肌组织中TGF - β1 的高表达 ,收缩压亦有明显的降低 (P <0 0 1)。结论　长期应用丹参可预防自发性高血压大鼠左室肥厚的形成 ,其机制可能与丹参降低了心肌细胞TGF - β1 的表达有关。     

丹参对高血压大鼠心脏醛固酮及心肌蛋白激酶C表达的影响

目的：研究丹参对自发性高血压大鼠(SHR)心脏醛固酮及左室心肌蛋白激酶C表达的影响。方法：用WKY大鼠做阴性对照组，SHR大鼠分为对照组和治疗组。治疗组给予丹参注射波腹腔内注射12周，其余两组分别注射相当容积的蒸馏水。测量大鼠动脉收缩压(SBP)及左室重量指数(LVMI)，用放免法测量心脏局部醛固酮含量，应用免疫组织化学方法则量左心室蛋白激酶C(PKC)表达。结果：与WKY大鼠相比较，SHR有较高的血压、LVMI增加、心脏局部醛固酮升高、PKC表达上调(P＜0．01)，而丹参治疗组用丹参治疗后，SHR除收缩压外余指标均显著性下降(P＜0．05)。结论：丹参能降低自发性高血压左室肥厚大鼠心脏醛固酮含量并使左室心肌蛋白激酶C表达减少。     

丹参酮ⅡA抑制高血压状态下心脏醛固酮合成及其相关基因的表达

背景醛固酮是左心室肥厚的主要致病因子,有效抑制其生物合成可防治高血压左室肥厚.目的观察丹参酮ⅡA对自发性高血压大鼠心肌醛固酮合成及其相关基因CYP11B1和CYP11B2表达的作用,以及其抑制高血压左室肥厚的可能途径.设计以自发性高血压大鼠为实验对象,以正常血压的WKY大鼠为对照,完全分组设计,随机对照实验,各组间均数的比较用方差分析.单位华中科技大学同济医学院附属同济医院急诊科和中西医结合研究所.材料实验于2003-01/2004-02在华中科技大学同济医学院附属同济医院急诊科实验室完成.选用12周龄雄性正常血压WKY大鼠10只为对照组,将12周龄雄性自发性高血压大鼠20只随机分为2组,每组10只,分别为高血压组和丹参酮ⅡA组.方法丹参酮ⅡA组经腹腔每天注射1.5 mg/kg丹参酮ⅡA,高血压组和对照组均腹腔注射相当容积的蒸馏水.实验12周后断头处死大鼠留取心肌标本,心肌组织醛固酮和血管紧张素Ⅱ含量采用放射免疫法测定,心肌醛固酮合成相关基因CYP11B1和CYP11B 2mRNA表达水平采用反转录聚合酶链反应检测.主要观察指标实验12周后各组大鼠心肌组织醛固酮和血管紧张素Ⅱ含量及CYP11B1和CYP11B2基因的mRNA表达量比较.结果自发性高血压大鼠20只和正常血压WKY大鼠10只均进入结果分析.①实验12周后大鼠心肌组织醛固酮含量高血压组和丹参酮ⅡA组均明显高于对照组[(0.056±0.014),(0.031±0.010),(0.018±0.009)ng/g,P＜0.01,0.05],丹参酮ⅡA组明显低于高血压组(P＜0.05).②实验12周后大鼠心肌组织血管紧张素Ⅱ含量高血压组和丹参酮ⅡA组均明显高于对照组[(0.093±0.016),(0.088±0.024),(0.043±0.012)ng/L,P＜0.01].③实验12周后大鼠心肌组织CYP11B1基因的表达量高血压组和丹参酮ⅡA组均明显高于对照组(2.774±0.138,2.533±0.127,1.973±0.102,P＜0.05).④实验12周后大鼠心肌组织CYP11B2基因的表达量高血压组和丹参酮ⅡA组均明显高于对照组(1.573±0.106,1.024±0.113,0.786±0.121,P＜0.01,0.05),丹参酮ⅡA组明显低于高血压组(P＜0.05).⑤各组大鼠心肌组织CYP11B1和CYP11B2及参照基因甘油醛-3-磷酸脱氢酶基因的反转录聚合酶链反应产物电泳带的位置与理论值相符.结论丹参酮ⅡA抑制高血压左室肥厚的效应可能与其下调心肌醛固酮合成相关基因CYP11B2的表达水平,减少心脏局部醛固酮的生物合成有关.     

Determination of creatine kinase isoenzyme MB activity in serum using immunological inhibition of creatine kinase M subunit activity. Activity kinetics and diagnostic significance in myocardial infarction.

This is a new method for the determination of creatine kinase isoenzyme MB activity in serum. The method uses direct activity measurement of creatine kinase B subunit activity after blocking of CK-M subunit activity by inhibiting antibodies. The test takes no longer than 15 min. The method yields an intra-serial C.V. of 2.0-12.9%, and a C.V. from day to day of 5.5%. The detection limit is 3.4 U/l creatine kinase MB. In the 95 cases with proven myocardial infarction several types of creatine kinase MB activity kinetics could be determined. The percentage of creatine kinase MB of peak CK-total is 6-25%, with a mean of 11.1%. The amount of creatine kinase MB with respect to total CK activity after reinfarction is higher than the amount after initial infarction.     

Dissociable correlates of two classes of retrieval processing in prefrontal cortex

Although substantial evidence suggests that the prefrontal cortex (PFC) implements processes that are critical for accurate episodic memory judgments, the specific roles of different PFC subregions remain unclear. Here, we used event-related functional magnetic resonance imaging to distinguish between prefrontal activity related to operations that (1) influence processing of retrieval cues based on current task demands, or (2) are involved in monitoring the outputs of retrieval. Fourteen participants studied auditory words spoken by a male or female speaker and completed memory tests in which the stimuli were unstudied foil words and studied words spoken by either the same speaker at study, or the alternate speaker. On "general" test trials, participants were to determine whether each word was studied, regardless of the voice of the speaker, whereas on "specific" test trials, participants were to additionally distinguish between studied words that were spoken in the same voice or a different voice at study. Thus, on specific test trials, participants were explicitly required to attend to voice information in order to evaluate each test item. Anterior (right BA 10), dorsolateral prefrontal (right BA 46), and inferior frontal (bilateral BA 47/12) regions were more active during specific than during general trials. Activation in anterior and dorsolateral PFC was enhanced during specific test trials even in response to unstudied items, suggesting that activation in these regions was related to the differential processing of retrieval cues in the two tasks. In contrast, differences between specific and general test trials in inferior frontal regions (bilateral BA 47/12) were seen only for studied items, suggesting a role for these regions in post-retrieval monitoring processes. Results from this study are consistent with the idea that different PFC subregions implement distinct, but complementary processes that collectively support accurate episodic memory judgments.     

俯卧位通气对高海拔地区肺复张治疗无效急性呼吸窘迫综合征患者氧合的影响

目的 探讨俯卧位通气对高海拔地区肺复张术(RM)治疗无效急性呼吸窘迫综合征(ARDS)患者的治疗作用.方法 从海拔2260m的地区医院筛选RM治疗无效的41例ARDS患者[平均氧合指数( PaO2/FiO2)较RM前升高＜20％视为RM无效],依不同病因分为肺内源性ARDS组(ARDSp组)和肺外源性ARDS组(ARDSexp组),每组再按信封法随机分为俯卧位组和仰卧位组,即ARDSp俯卧位组(11例)、ARDSp仰卧位组(9例)、ARDSexp俯卧位组(10例)、ARDSexp仰卧位组(11例).在通气前及通气1、2、3、4h监测动脉血氧分压( PaO2)、PaO2/FiO2、静态顺应性(Cst)、气道阻力(Raw)的变化.结果 通气lh时,ARDSexp俯卧位组PaO2/FiO2( mm Hg,l mm Hg=0.133 kPa)即较通气前显著升高(157.4±40.6比129.3±48.7,P＜0.05),并随通气时间延长呈持续增高趋势,4h达峰值(219.1 ±41.1);且ARDSexp俯卧位组通气3h内PaO2/FiO2较其他3组显著增高,另3组间则差异无统计学意义.ARDSp俯卧位组、ARDSexp俯卧位组通气4h时PaO2/FiO2均较相应仰卧位组显著增高(208.8±39.7比127.4±47.1,219.1±41.1比124.9±50.8,均P＜0.05).4组通气前后Cst无显著改变,各组间差异也无统计学意义.ARDSp俯卧位组通气4h时Raw(cmH2O·L-1·s-1)较通气前显著降低(6.8±1.7比10.7±1.8,P＜0.05),且明显低于其他3组;其他3组各时间点Raw组内及组间比较差异均无统计学意义.结论 俯卧位通气作为ARDS机械通气重要策略之一,可以改善RM无效高原ARDS患者的氧合,为抢救患者赢得宝贵的时间.     

Digital imaging among medical facilities

The Department of Veterans Affairs (VA) in the USA operates a network of 172 medical centres which all utilize a hospital information system (HIS) which has been developed and is currently maintained by the VA. During the past several years, an image management and communication module has been developed, installed and clinically utilized at the Washington DC and Maryland VA Medical Centres. This image management and communication system, referred to as the decentralized hospital computer program (DHCP) imaging system, is fully integrated with a commercial picture archiving and communication system (PACS). The system is utilized to capture, archive, and display all images generated within the hospital including radiology, nuclear medicine, pathology, endoscopy, bronchoscopy, and dermatology, intraoperative photographs, ECG data, and a limited number of paper documents. The ultimate goal of the project is to have all patient text and image data available at any clinical workstation to any authorized user anywhere within the network of medical centres. Clinical requirements for an imaging workstation include ease of use, rapid and reliable access to the complete set of patient information, and images which are of acceptable quality to meet the requirements of the user and the subspecialty. Patient confidentiality and data security must be safeguarded at all times. Integration of the images with the remainder of the patient's database was found to be critical to the success of the project. The experience at the Washington and Maryland facilities suggests that an imaging system that is successfully integrated with a hospital information system can provide substantial clinical and economic benefits both within and among medical centres. Clinical acceptance and utilization of the system has been excellent, particularly in diagnostic radiology where DHCP Imaging has been interfaced to a commercial PAC system. Based upon this initial experience, the VA has begun to deploy the system throughout its large network of medical centres.     

Myocardial elastography at both high temporal and spatial resolution for the detection of infarcts

Myocardial elastography is a novel method for noninvasively assessing regional myocardial function, with the advantages of high spatial and temporal resolution and high signal-to-noise ratio (SNR). In this paper, in-vivo experiments were performed in anesthetized normal and infarcted mice (one day after left anterior descending coronary artery [LAD] ligation) using a high-resolution (30 MHz) ultrasound system (Vevo 770, VisualSonics Inc., Toronto, ON, Canada). Radiofrequency (RF) signals of the left ventricle (LV) in longitudinal (long-axis) view and the associated electrocardiogram (ECG) were simultaneously acquired. Using a retrospective ECG gating technique, 2-D full field-of-view RF frames were acquired at an extremely high frame rate (8 kHz) that resulted in high-quality incremental displacement and strain estimation of the myocardium. The incremental results were further accumulated to obtain the cumulative displacements and strains. Two-dimensional and M-mode displacement images and strain images (elastograms), as well as displacement and strain profiles as a function of time, were compared between normal and infarcted mice. Incremental results clearly depicted cardiac events including LV contraction, LV relaxation and isovolumetric phases in both normal and infarcted mice, and also evidently indicated reduced motion and deformation in the infarcted myocardium. The elastograms indicated that the infarcted regions underwent thinning during systole rather than thickening, as in the normal case. The cumulative elastograms were found to have higher elastographic SNR (SNR(e)) than the incremental elastograms (e.g., 10.6 vs. 4.7 in a normal myocardium, and 6.0 vs. 2.4 in an infarcted myocardium). Finally, preliminary statistical results from nine normal (m = 9) and seven infarcted (n = 7) mice indicated the capability of the cumulative strain in differentiating infracted from normal myocardia. In conclusion, myocardial elastography could provide regional strain information at simultaneously high temporal (>/=0.125 ms) and spatial ( approximately 55 microm) resolution as well as high precision ( approximately 0.05 microm displacement). This technique was thus capable of accurately characterizing normal myocardial function throughout an entire cardiac cycle, at the same high resolution, and detecting and localizing myocardial infarction in vivo.     

Clinical Pharmacokinetics of Morphine

Morphine, the most widely used mu-opioid analgesic for acute and chronic pain, is the standard against which new analgesics are measured. A thorough understanding of the pharmacokinetics of morphine is required in order to safely and effectively use this analgesic in a wide variety of patients with different levels of organ function. A MEDLINE search was conducted to identify literature published between 1966 and January 2002 relevant to the pharmacokinetics of morphine. These publications were reviewed and the literature summarized regarding unique and clinically important elements of morphine disposition relative to its parenteral administration (including intravenous, intramuscular, subcutaneous, epidural and intrathecal administration), absorption profile (immediate release, controlled release, and sublingual/buccal, and rectal administration), distribution, and its metabolism/ excretion. Special populations, including infants, elderly, and those with renal/liver failure, have a unique morphine pharmacokinetic profile that must be taken into account in order to maximize analgesic efficacy and reduce the risk of adverse events.